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Overview

Cholera is an infection of the small intestine by the bacterium Vibrio cholerae. ^{[1] [2]}

Symptoms

Symptoms may range from none, to mild, to severe ^[2], but the classic symptom is large amounts of watery diarrhea, that lasts a few days. ^[3]

Other symptoms

Vomiting, and muscle cramps may also occur with the disease . ^[2]

Dehydration

Diarrhea can be so severe, that it leads to severe dehydration, and electrolyte imbalances within hours. ^[3]

Signs of dehydration

Severe dehydration can give the patient sunken eyes, cold skin, decreased skin elasticity, and wrinkling of the hands and feet. ^[4] Dehydration can cause the skin to turn bluish. ^[5]

Timing of symptoms

Symptoms typically start two hours, to five days after exposure. ^[2]

Cause

Cholera can be caused by different types of Vibrio cholerae, with some types producing more severe disease than others, which can make some outbreaks more severe than others. ^[3]

Spread

The main cause of Cholera is drinking unsafe water, that has been contaminated with human feces containing the bacteria, or unsafe food contaminated by infected water. ^[3]

Poorly cooked food

Undercooked seafood is a common source for the disease. ^[6], and humans are the only animal affected. ^[3]

Risk factors

Risk factors for the disease include poor sanitation, not enough clean drinking water, and poverty. ^[3]

Effect of global warming

There are concerns that rising sea levels, caused by global warming, will increase rates of disease. ^[3]

Diagnosis

Cholera can be diagnosed by a stool test. ^[3]

Prevention

Prevention methods against cholera include improved sanitation, access to clean water, and good hygiene. ^[4]

Vaccination

Cholera vaccines that are given by mouth, provide reasonable protection to the disease for about six months ^[3], and, they have the added benefit of protecting against another type of diarrhea, caused by E. coli. ^[3]

Treatment

The primary treatment is oral rehydration therapy—the replacement of fluids with slightly sweet and salty solutions. ^[3] Rice-based solutions are preferred. ^[3]

Zinc

Zinc supplementation is useful in children. ^[7]

IV fluids and antibiotics

In severe cases, intravenous fluids, such as Ringer's lactate, may be required, and antibiotics may be beneficial. ^[3] Testing to see which antibiotic the cholera is susceptible to, can help guide the choice. ^[2]

Epidemiology

Cholera affects an estimated 3–5 million people worldwide and causes 28,800–130,000 deaths a year. ^{[3] [8]}

Developing nations

Although it is classified as a pandemic disease as of 2010 ^[update], it is rare in the developed world, ^[3]and affects mostly the children of developing countries. ^{[3] [9]}

Outbreaks vs chronic disease

Cholera occurs as both outbreaks, and chronically in certain areas. ^[3] Areas with an ongoing risk of disease, include Africa, and Southeast Asia. ^[3]

Risk of death

The risk of death among those affected is usually less than 5%, but can be as high as 50%. ^[3] Not having access to treatment dramatically increases the risk of death. ^[3]

History

Descriptions of cholera are found as early as the 5th century BC in Sanskrit. ^[4] The study of cholera in England by John Snow, between 1849 and 1854, led to significant advances in the field of epidemiology. ^{[4] [10]} Seven large outbreaks have occurred over the last 200 years, with millions of deaths. ^[11]

References